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Dáil Éireann debate -
Wednesday, 18 Oct 1978

Vol. 308 No. 4

Private Members' Business. - Hospital Appointments: Motion (Resumed).

Debate resumed on the following motion:
That Dáil Éireann calls on the Minister for Health to fully implement the arrangements for a federation as negotiated between the Western Health Board and the management of Portiuncula hospital in regard to the Roscommon County Hospital, thereby ensuring a full scale maternity unit in the county and, to this end, to take whatever steps to ensure that such appointments of professional staff as are necessary to honour the agreement, be made without further delay.
—(Deputy Mrs. Burke.)

Before I finished last night I was referring to the unfortunate position that arose because of statements made locally in Roscommon suggesting that a civil servant had refused to obey a ministerial directive. I suggested it was a pity that the position had not been clarified and a contradiction published by the Minister as soon as the statements were made. I am unhappy that although the Minister's speech last night went some way to explain the position, it did not clearly indicate that he could not have given a directive in this case because it was not within his compass to do so.

In fairness to the staff involved, a clearer indication should have been given at a much earlier date of what the position was because it was unfortunate that the staff should have been involved in an argument to ventilate local view-points. I hope I will have another opportunity to deal with that.

The words of this motion have been taken from the Minister's letter of 24 March 1977 in which he undertook to provide for a federation between the Roscommon County Hospital and Portiuncula. In accordance with the terms of that federation there was to be an appointment of an obstetrician/gynaecologist. The unhappiness and the public protest were caused because that undertaking has not been implemented. The Minister now says he is trying to implement it. That is not the undertaking that was given. The undertaking was that the appointment would be made and that is what the motion has asked for.

First of all, I wish to refer specifically to the outrageous personal attacks made on me last night by Deputies Boland and L'Estrange. Deputy Burke is my colleague in the constituency. She is respected by all and sundry. She has headed the poll consistently in the constituency and I ask her personally to dissociate herself from the intemperate remarks by those two Deputies. They were a disgrace to their party and to their constituents. I know Deputy Burke, a respected and honourable lady, will dissociate herself from those remarks. The irresponsible contributions last night of those two Deputies reflected on themselves, on their party and on the motion. The jokes by Deputy L'Estrange about draining the Shannon and other remarks by Deputy Boland brought the debate to a low level and I hope that when Deputy Burke is replying she will dissociate herself from those remarks and earn the respect of her constituency.

Nobody has been associated more closely with or has had a greater personal interest in this hospital than I, and I can go back to my birth in this hospital 33 years ago. Naturally one would have a close relationship with the hospital in which one was born. I am the first Deputy from Roscommon town to be elected in 54 years. Prior to my election to the Dáil I was deeply involved in this hospital, even prior to my council election in 1974, but particularly since the FitzGerald Report in 1968. I was among the first to launch a campaign against that report and I fought consistently during the years about any downgrading of Roscommon County Hospital. I worked for the improvement of that hospital, prior to my election and since my election. There is no Minister more approachable in matters of this kind than Deputy Haughey. He has met me and my colleague, Deputy Doherty, on occasions too numerous to mention, to discuss the whole future of the hospital in federation with Portiuncula.

I appreciate the Minister's commitment to this federation which he outlined so clearly last night. I have the fullest confidence in the manner in which the Minister is handling this situation.

I will refer again to my personal involvement in this hospital. My parents owe their lives to the fact that this hospital was operating effectively and was in a position to treat their complaints over the years, particularly since they became elderly. I will continue my campaign within Fianna Fáil, with the support of Deputy Doherty and of the people of the constituency who sent me here. This hospital was totally neglected by the previous administration.

To deal specifically with the maternity side of the hospital, at the moment we have 25 maternity beds with all the ancillary services necessary for safe deliveries, including nursing and medical staffs. We are looking for a qualified obstetrician/gynaecologist to work in that unit with the midwife-nurses and the trained backup nursing and medical staffs. I would have complete confidence in a maternity unit which would have an obstetrician/gynaecologist. I hope the negotiations that are proceeding and will proceed with Comhairle na nOispidéal will come to fruition and I am reasurred by the Minister's statement that he will not stand in the way and that he will make the necessary funds available.

Since the appointment of this Government many major programmes have been implemented in the Roscommon hospital. Since the last election we have sought and have obtained the permanent appointments of a surgeon and a physician to that hospital. We have also obtained major improvements in the hospital which have enabled us to provide a first class service in the medical and surgical wings. There was the permanent appointment last October of a consultant physician, Mr. McHugh, a few months after the appointment of this Government. A consultant surgeon, Mr. Michael Relihan, was appointed on 1 November 1977. At the time, the CEO reported:

Most favourable comments from the patients and their relatives as well as the family doctors in County Roscommon have been received for the very substantial increase in the workload of the hospital in Roscommon. In the current financial year many improvements have been carried out at the County Hospital, Roscommon, including the provision of a new accident department, operating theatre and coronary unit as well as an arrangement for the supply of sterile goods from the Hospitals Joint Service Boards.

Without doubt it is an excellent hospital which has been improved to a great extent since June 1977. That is what I had been fighting for over the years—the upgrading of this hospital. The hospital has been upgraded and I am proud to be associated with the improvements.

I have in my possession details of the number of admissions and operations but I will not go into that because of my limited time. The existence of this hospital has saved many lives, victims of serious car accidents, in the last few months. As late as last weekend, five young men were involved in a serious car accident. Unfortunately one of them was fatally injured, but the other four are making satisfactory recoveries in the hospital. We are very thankful that this hospital was there to save the lives of these young people and many more people. The former Minister for Health, Mr. Seán Flanagan, had a serious accident and due to the work of Surgeon O'Hanrahan, Dr. Walls and others he made a very satisfactory recovery.

I do not know why Deputy Mrs. Burke is playing politics with the lives of the people of Roscommon. I am surprised that she is using this opportunity to try to embarrass the Government or the Deputies from the constituency. She is not helping the situation. This Private Members' motion is faulty in its presentation. The way in which it is proposed is incorrect and, under Standing Orders, I shall ask later if it can be taken as it stands. I shall seek clarification on the matter in a few moments.

I am surprised and disappointed that my colleague, Deputy Burke, should come here and use the opportunity to embarrass the Government or to play politics with this important issue. This issue is above and beyond political consideration. So far as I am concerned, my political future is of no consequence so long as Roscommon County Hospital has the necessary services. So long as that happens I shall be content to carry on with my other work and go out of this House but while I am in the House I shall fight for the services in the Roscommon County Hospital. I am quite hopeful that I shall have the backing of the Government and the Minister.

I would ask Deputy Burke about the inactivity for four-and-a-half years when the former Minister for Health, Deputy Corish, did not bother to examine the situation to see if there could be a solution to the federation discussions that were taking place. It was a period of total inactivity so far as the hospital in Roscommon was concerned. Deputy Mrs. Burke is a member of Fine Gael and she must take responsibility for the inactivity of the former Minister for Health so far as Roscommon was concerned. I know that she will accept that responsibility. So far as Deputy Corish was concerned, Roscommon was totally irrelevant because he knew there were very few votes there for his party. The supporters of the National Coalition were not able to persuade him to supply the necessary finances to support any federation proposals.

I appreciate what Deputy Burke said last night in relation to the major developments that are taking place in our constituency. These developments will provide more jobs, more investment and more confidence in the future. If there are more births in the area this will strengthen our hand when we are fighting for this appointment in Roscommon. I am delighted that she has recognised the major contributions of the Government in the development of the area in the past 16 months. I am working not only for the future of the hospital but also for the economic needs of the area. It is gratifying that Deputy Burke has accepted what has been done in the recent past.

Last night Mrs. Burke quoted from newspapers. I am not going to indulge in petty politics here. I am not going to comment on what journalists wrote in certain newspaper on a certain date. The people will judge what has happened. I have been outspoken with regard to the hospital but this is because I am fighting for the people of Roscommon. If journalists do not quote me correctly that is their business. I am a politician and I do my business. If I am misquoted so be it, but the people will judge the situation as it arises. I am not going to delve into papers of a few years ago or to comment on what was said by Deputies then. I shall not even refer to the Roscommon Herald of January 1977 when an article stated that Mrs Burke reassured the people——

The Deputy should refer to Deputy Mrs. Burke.

I shall not refer to an article in the Roscommon Herald about what Deputy Burke said before the election. She reassured the people——

I was referring to the medical and surgical side.

She reassured the people that they did not need to worry about the hospital. She told them that it was secure and that she and her Government would make sure that was the case. I knew what the previous Government were setting out to do. They were setting out to close the hospital and that is why the people put me into this House to ensure that I would fight for the hospital, that it would not be downgraded or closed. I am glad to say it will not be closed but will be upgraded.

I wish to refer again to an article in the Irish Independent of 26 August 1978. Deputy Burke did not quote me fully or correctly in her contribution last night. The sub-editors in the Irish Independent are responsible for the headlines they use. The headline they used in this case was: “Deputy to Challenge Powers of Hospital Body in Dáil”. That is not what I said. I said that I would ask the Minister for Health to amend section 41 of the Health Act, 1970 and I am repeating that request to the Minister now. He should bring in the necessary amending legislation to change section 41 to enable him to have the ultimate say in relation to the appointment of specialists in hospitals throughout the country. Basil Chubb, Chairman of Comhairle na nOspidéal, is not the Minister for Health. I would ask the Minister to ensure that he alone has the ultimate say.

I would ask the Deputy not to use names of people outside the House.

He is so involved in this issue I cannot avoid mentioning him.

It may be difficult but it should not be done because the person concerned is not here to defend himself.

The Chairman of Comhairle na nOspidéal should not be above and beyond the Minister for Health. The Minister was elected by the people and he has the support of 83 Deputies in this House. He has the support of the people. I was elected by the people but the chairman and Comhairle na nOspidéal were not elected by the people and do not have to answer to them. I would ask the Minister to grasp the nettle. He should amend section 41 of the 1970 Act to enable him to have the ultimate say in the appointment of specialists in hospitals throughout the Twenty-six Counties.

If he does not, will the Deputy bring in his own Bill?

Last night Deputy Burke stated that there were no women on Comhairle na nOspidéal but I beg to differ with her. There is a lady on the board; she is from Drogheda and is a Reverend Sister. I hope she is doing a good job on the board. I agree that there should be more women on the board but I would again point out that Sister Bosco McNamara from the Lourdes Hospital in Drogheda is a member of the present board who will cease to hold power on 30 September 1978. I hope that the new comhairle will have not only women but a fair representation from areas throughout the country and a fair geographical spread of interest. I hope, too, that it will not be stacked with high-powered and highly-paid medical specialists having very vested interest in ensuring that they will not have single obstetric units because of the small amount of money involved in comparison with a very big unit. I ask the Minister to ensure that the proper spread of interests is represented in this new comhairle which will take up office in 1979.

I make no apology for stating here as I have stated outside this House that I have no faith in the present Comhairle na nOspidéal because that comhairle tried to close the surgical end of Roscommon County Hospital in 1975. They were prevented from carrying out that outrageous policy at the time. Please God, their views concerning the appointment of an obstetrician/gynaecologist in Roscommon will also be vetoed and we will succeed in having this very important appointment made in the not-too-distant future. I have complete confidence in the Minister because he is most able, alert and active. He is certainly an outstanding Minister who has the best interests of the people of this country and of Roscommon at heart. I have no doubt of his integrity as far as this is concerned and I know he will ensure that every consideration is given in relation to the appointment in Roscommon. He said in his statement last night:

At the outset I wish to make it clear that I subscribe fully to the proposed federation between Portiuncula Hospital, Ballinasloe, and the County Hospital Roscommon. I am anxious that the arrangements under the federation should be implemented as soon as possible. So far as I am concerned there will not be any obstacle placed in the way of their implementation.

I welcome that as a statement of policy from the Minister for Health, from his Department and from the Government. He went on to state that agreement was reached on the establishment of joint departments straddling the two hospitals in surgery, medicine, radiology and so on and he said:

These arrangements would involve the consultants in each specialty in the two hospitals providing consultancy cover for both hospitals on a continuous basis and with the Portiuncula consultants providing services at Roscommon County Hospital as required.

I ask him to provide the same joint departments of surgery and medicine at the moment and the joint departments of obstetrics and gynaecology between the two hospitals. With that we would have a top-rate service for the people of part of County Galway and the whole of County Roscommon. The appointments should be made as quickly as possible because delay in the appointment of this specialist service is damaging to the possible and proposed federation between the two hospitals.

Recently I had a public debate with the people in Portiuncula Hospital and I asked them to honour an alleged agreement between the Western Health Board and themselves and to bring the necessary negotiations to a fruitful conclusion. I ask anybody in a position of influence to ensure that these negotiations will continue and will have a satisfactory outcome. I ask the movers of this motion what agreement they are talking about. It is vital that we know because quite a lot of negotiations have taken place. The wording of this motion is ambiguous and dangerous to the possible conclusion of an arrangement between Portiuncula and the Western Health Board in relation to the facilities at Roscommon County Hospital. Are they referring to an alleged agreement which took place on 30 September 1976 between the Western Health Board and the authorities in Portiuncula which was not ratified by Deputy Burke's Government between that date and 5 July 1977? After all the pressures that came from Roscommon County Council, the local health committee, the Western Health Board and all the councillors, Deputy Corish was not prepared to meet the health board or to ratify that agreement.

I also welcome the Minister's statement last night that he would meet the Western Health Board in due course after they have discussed the situation with Comhairle na nOspidéal. I ask the movers of this motion if they are referring to that alleged agreement or to negotiations which took place recently which would result in the non-appointment of an obstetrician/gynaecologist in the maternity wing of Roscommon County Hospital. I will not support any move, irrespective of who makes it, to deprive Roscommon County Hospital of an obstetrician/gynaecologist.

The motion states:

That Dáil Éireann calls on the Minister for Health to fully implement the arrangements for a federation as negotiated between the Western Health Board and the management of Portiuncula hospital in regard to the Roscommon County Hospital, thereby ensuring a full scale maternity unit in the county and, to this end, to take whatever steps to ensure that such appointments of professional staff as are necessary to honour the agreements, be made without further delay.

Many agreements and discussions have taken place. The last agreement, negotiation or discussion which Comhairle na nOspidéal will support would deprive Roscommon County Hospital of an obstetrician/gynaecologist. I hope that Deputy Burke is not suggesting that we do not have an obstetrician/gynaecologist in the County Hospital in Roscommon. If she is suggesting that I ask her not to go back to the people of Roscommon because they want that service there. Otherwise I ask the movers of the motion to amend this resolution in some way which will ensure that it is quite clear and without doubt or ambiguity what their intentions are. I doubt their intentions and I question their integrity. In June of last year when I was elected to this House in Roscommon I knew their intentions as far as Roscommon was concerned. They were ambiguous and they lacked the integrity and sincerity which would result in a satisfactory conclusion of the proper services in Roscommon County Hospital.

The people of Roscommon did not know the Deputy's intentions at that time.

They are being put forward again here tonight in this resolution. If Deputy Donnellan is at the same low, dragging, degrading type of activities which Deputy L'Estrange and Deputy Boland were at last night I ask Deputy Burke to dissociate herself from them because she is not the type of lady who would be seen and heard associating with that low, cowardly behaviour unbecoming to any Member of this Dáil.

Poor old Doherty.

The Deputy has one minute to conclude, without interruption.

The Deputy is inviting interruptions.

Deputy Donnellan will have to keep quiet if he wishes to remain in the House.

I should like to know if the movers of the motion are referring to a proposal put forward by the authorities of Portiuncula Hospital on 4 May 1978 to the Western Health Board. The authorities of that hospital proposed the non-appointment of an obstetrician/gynaecologist in the maternity wing of Roscommon County Hospital. It is those negotiations that the movers of the motion are in favour of. I hope the Government will not accept any such proposals because they would mean that an obstetrician/gynaecologist would not be appointed in Roscommon County Hospital. I am for such an appointment in Roscommon and I am against a motion like this which seeks to damage our county hospital.

The next motion will be on literacy standards in Roscommon.

My support for the federation between the Portiuncula and Roscommon Hospitals was based on my concern for the mothers and children of Roscommon and surrounding areas. For too long we have had to live with certain ailments and tragedies because the necessary and vital services for mothers and children were not available. It is important to note that we never had an obstetrician/gynaecologist in County Roscommon and that it was not until 1968 that a maternity wing was provided at the county hospital. Once that wing was erected it was only natural that the people of the county, and those with a genuine interest in having the proper services made available, would seek to have the proper staff appointed.

In the course of his contribution last night the Minister expressed his concern about this matter. He was concerned to the extent that he was prepared to go to all reasonable and realistic lengths to ensure that such a desirable and important service would be provided, if possible. This statement was positive and left no doubt in my mind that the Minister was genuinely concerned about the care of those requiring obstetrics and gynaecological services.

It should also be mentioned that we do not have a paediatric service in Roscommon, a service which is of vital importance. While mothers are well cared for in modern times children must also be put on equal footing to ensure that their health after birth is looked after. In the days after birth it is important that problems are detected so that remedial action can be taken. It is only natural that the people of County Roscommon were disappointed at the decision of Comhairle na nOspidéal. It is not my function to defend Comhairle na nOspidéal and I am concerned with the need for a proper service. I understand the reason why Comhairle na nOspidéal was established. It consists of experts in the medical field whose advice we value. While I may not agree with the decision Comhairle na nOspidéal reached in relation to Roscommon County Hospital, I must support the Minister when he says that we cannot dispute their medical opinion. We must value their medical advice.

However, there is a difference between medical opinion and social justification, a view which the Minister has made known here and outside. I am satisfied that if it was economically viable the Minister, and other Ministers, would provide maximum services of the highest standard everywhere. We must take into consideration that it is not possible to have everything throughout the country. On social grounds, there is a justifiable case to be made for that appointment.

Some of the proposals suggested by the federation have been provided. There is a surgical registrar, a medical registrar and an anaesthetist in the county hospital. This is a significant improvement. I am glad to tell the House that all the personnel in that hospital are valued very highly by the people of County Roscommon. It is only right that on their behalf I pay a tribute to the staff for the service they are giving to the county.

Although they are giving a maternity service at present, they would like to know that there are specially qualified people on hand to deal with this work. They feel that patients at risk can be isolated through their general practitioners and advised where to go. That is causing the problem. The county hospital in Roscommon could be providing a better maternity service if qualified and skilled personnel were available. Because this personnel is not available, expectant mothers have to travel quite a distance over some bad roads, often at unusual hours of the night, and this can be quite upsetting.

It has been said that it would be nice to have all these services at our doorstep. I do not think the people of Roscommon wish that to be the case. They merely wish that the federation would be implemented in full. I appreciate the views of an Comhairle on medical grounds but I differ with them on social grounds. I believe the people in Roscommon have the same entitlement to the best possible services as the people in Dublin.

I am very concerned about the less well off people in our community. In today's society the responsibility and function of any Government Minister or politician should be to ensure that the least well off members of our community are afforded protection by the Government and the agencies of State. In Roscommon we have a medical card population in the region of 60 per cent. They are entitled to the best possible services and to the same services as those who can afford them. Even if they cannot really afford it, many men make every effort to get the money to pay for the best service available. Many women who go to Roscommon Hospital to have their babies are not medical card holders. Some women have great faith in that hospital. It would be a pity if medical card holders were forced to accept less than the best service to which they are entitled, simply because they could not afford to go elsewhere.

It is significant to note that protracted negotiations are still taking place. The Minister has made every effort within the legal limitations imposed on him to bring about a suitable and acceptable solution to the problem in Roscommon. He has devoted a great deal of time to me, to Deputy Leyden, Deputy Burke and other public representatives in our constituency, to argue the case for the appointment, but the advice given to him through Comhairle na nOspidéal does not consider the appointment in Roscommon Hospital desirable on medical grounds. This is the Minister's dilemma.

I agree with this motion in principle. It would be wrong to suspect or accuse Deputy Burke or Deputy Boland of putting down this motion for political purposes. They put it down to get the help which is needed, but I accept that there is a certain amount of political play in the motion as it stands. It is only natural that Opposition Deputies get their pound of flesh out of an issue, such as the county hospital in Roscommon, which has got considerable publicity at local and national level.

As this motion is worded it cannot in all fairness be supported by the House. While, as I said, I agree with it in principle, I also agree with the Minister. The motion requires that the Dáil command the Minister to do something he has no statutory power to do. I do not wish Deputy Boland to take any personal offence at what I am about to say, but as shadow spokesman for health I expected more of him. I expected him to know the legal responsibilities of a Minister in this regard. If he had known, the motion would have been worded differently.

It would be regrettable if Deputy Burke and I, two Deputies from the same constituency, with the same aims, had to divide on this motion because it was incorrectly worded. That is the case with this motion. It would be even worse if we had to divide on it having regard to the fact that we are and have been at one on this issue both at local authority and health committee levels and at all the public meetings we attended. It would also be regrettable if we had to come to Dublin and divide on the motion although we have the same aims. It would be regrettable too if the people of Roscommon thought that the motion was proper and just when it is not and does not reflect the actual position Deputy Burke or Deputy Boland want to achieve.

The natural temptation is to make that little bit of political play to embarrass Deputy Leyden and myself, but I am not concerned about any embarrassment it might bring me. I am concerned about how existing negotiations will progress, how, at some time in the future, the possibility of that acceptable solution providing proper services can be found by the Minister. Certainly the Minister, as he has said time and again, is trying to seek that acceptable solution in the best interests of mother and child.

As a backbencher it is a pity I have to tell Deputy Boland that he should have known more when putting down the motion. I am quite sure he has read the Health Act and that he is aware of section 41 of that Act. It would be a pity that he be allowed leave this House this evening without knowing he had made a mistake. It would be an even greater pity that Deputy Mrs. Burke would not be informed of this fact also. Deputy Burke may have meant well but the way in which this motion has been framed can be described as being divisive. Certainly I do not want that.

Surely the Minister must have known that when he wrote the letter on 24 March 1977.

Deputy Doherty without interruption.

The Minister, both in his capacity as shadow Minister for Health, prior to the last election and since he became Minister for Health, has displayed the same continuity in his interest in the people of Roscommon and in this particular appointment to the county hospital. There has been no change whatsoever in his attitude; I stand here as a witness to that.

I regret that the whole tone of this debate has not been as serious as I would have liked. I could name various villages and townlands in County Roscommon. I might read well. People in Roscommon might feel they were going to have a gynaecologist in every townland. Deputy Mrs. Burke did that last evening: I will not do it. Indeed she included Clondra, which is in County Longford, not in County Roscommon. She may not have known but the Minister announced recently an expenditure of £5 million for Mullingar Hospital which will cater for the needs of Longford and Westmeath.

I support the motion in principle but I cannot support it formally because it has been improperly set before the House.

Why did the Deputy not move an amendment?

It is not the function——

At this stage Deputy Doherty has about eight minutes to conclude and he should not be interrupted. Certainly he has said nothing on which anyone could interrupt him unlike some of the speeches we had last evening.

He did last evening.

In my opinion it is not the function of the Minister to tell Deputy Boland or Deputy Mrs. Burke how to put down a motion. The fact that they have put it down so badly means that one cannot amend something that is wrong, fundamentally wrong. It is as simple as that.

In view of the fact that negotiations are still progressing I should like to think we would make every possible effort to bring about a reasoned and sensible approach to this whole matter, that we would concern ourselves with and take the advice of the medical people. Indeed, there is divided medical advice. The Minister acknowledged that fact last evening. It is acknowledged by the Western Health Board. Furthermore, it is acknowledged by the people in Roscommon close to this matter. I, too, acknowledge that there are divided medical views and opinions on this matter. Regardless of the fact that there may be divisions on the medical views, nevertheless all of the medical people are placing their priorities correctly.

I am not in a position to debate the medical justifications or otherwise, but I am in a position to argue the social need, requirement and justice of having the service in Roscommon. Certainly I am not going to use the County Hospital in Roscommon or the case for the provision of the proper obstetrical and gynaecological services there as a political football. They deserve more than that. The people in County Roscommon who will benefit from the service deserve more than a lot of trash and nonsense at local or national level when such an important matter has to be decided. For that reason I would ask the two Deputies who put their names to the motion to accept that I agree in principle but I cannot support it because of the illegality of the way it is set out.

Deputy Mrs. Joan Burke to conclude.

Deputy Boland rose.

Deputy Mrs. Burke is nominating Deputy Boland to conclude.

Deputy Doherty, in a very reasoned speech, suggests that, while he is in favour of the motion in principle, he cannot agree with it because it is, in one phrase, fundamentally bad and, in another, not enforceable by the Minister.

I want to point out that the motion suggests that the Minister should:

...fully implement the arrangements for a federation as negotiated between the Western Health Board and the management of Portiuncula Hospital in regard to the Roscommon County hospital, thereby ensuring a full scale maternity unit in the County....

I want further to remind the House, lest Deputy Doherty might worry about my knowledge as shadow Minister——

Sorry, Deputy Boland, the Chair is in a very awkward position here. As Deputy Boland has spoken previously on the motion apparently the precedent down the years has been that he cannot then reply to it: either the proposer of the motion or somebody else who has not already spoken can reply.

Would the Chair quote the relevant Standing Order?

Standing Order No. 86 (3) reads:

The speech of a member proposing a motion to which any time limit applies shall not exceed forty minutes and the member proposing, or such other member who has not already spoken as he may authorise in that behalf, shall be entitled to not less than fifteen minutes for a speech in reply;...

Sorry, it is the Chair's fault. I was not quite up with the motion.

I accept that.

Deputy Mrs. Burke must reply or nominate someone who has not already spoken.

On a point of order, I must point out that the motion is put down jointly by myself and Deputy Mrs. Burke. The motion was proposed in our joint names. Deputy Mrs. Burke spoke first and I spoke then.

It is the proposer of the motion that has the right to reply, or somebody nominated by her who has not already spoken.

I spoke at the next available opportunity. I understood that the motion was proposed in our joint names.

Only one person may propose any motion.

I accept that the Chair realises that I discussed this situation with him earlier today, and I was given to understand that——

I understand that. At that stage I was not quite up with the motion as I should have been.

I must accept the ruling of the Chair.

That is the Standing Order. I am sorry, Deputy. Deputy Mrs. Joan Burke to reply to the motion.

(Cavan-Monaghan): I take it that the time runs from now.

This is timed to conclude at 8.30 p.m.

I am sorry that my two colleagues cannot support the motion that they have accepted:

That Dáil Éireann calls on the Minister for Health to fully implement the arrangements for a federation as negotiated between the Western Health Board and the management of Portiuncula hospital in regard to the Roscommon County hospital, thereby ensuring a full scale maternity unit in the County and, to this end, to take whatever steps to ensure that such appointments of professional staff as are necessary to honour the agreement.

The Deputies have said that we are playing politics with this motion and that we did not understand section 41 of the Health Act. Surely the present Minister, who is regarded by Fianna Fáil as being a responsible person, should have known the facts when he wrote a letter to Dr. H. Gibbons, TD, which was published in the Roscommon Herald on 1 April 1977, which stated that the Fianna Fáil spokesman for health, Mr. C.J. Haughey, TD, had given a firm under-taking that the next Fianna Fáil Government would fully implement the arrangements for the federation of Roscommon and Ballinasloe hospitals as already negotiated. The announcement was made at a Roscommon-Leitrim Fianna Fáil constituency dinner in Roscommon last Friday night by Dr. Hugh Gibbons, TD, when he read a letter which said:

Dear Hugh,

Following our recent discussion on the situation in county Roscommon and the need for a full-scale maternity unit in the county, I have carefully considered the matter. I now wish to give a firm undertaking that the next Fianna Fáil Government will fully implement the arrangement for a federation, which has been negotiated between the Western Health Board and the management of Portiuncula Hospital in regard to the Roscommon County Hospital.

That is exactly the wording of the motion.

The letter was dated 24 March 1977.

We heard all this last night. Are we having repetition?

I know, but apparently the Deputy's two colleagues did not hear it.

Loss of memory seems to run right through the Fianna Fáil Party.

Deputy Mrs. Burke, without interruption.

Deputy Colley, the Fianna Fáil spokesman on finance, was the chief speaker at the dinner. If those Ministers are that responsible they should have known that this could not happen. The original proposal referred to by Deputy Leyden contained in the Fitzgerald report which was published in 1968 was accepted in principle by the then Minister for Health, Deputy Seán Flanagan. If that proposal had been accepted then, it would have meant that the surgical and medical services and the accident service provided by Roscommon hospital would have been withdrawn. It seems ironic that Mr. Seán Flanagan was subsequently treated in Roscommon hospital. Had the services been withdrawn I would hate to think where Mr. Seán Flanagan would be to-day.

The next Minister, the late Mr. Childers, nominated Comhairle na nOspidéal on foot of that report, and this is the body that we are now trying to get rid of in section 41 of the Health Act. Before the Coalition Government took office in 1973 I was very concerned that the surgical, medical and accident department services of Roscommon hospital would be completely wiped out. very day of the week serious accident cases are being treated in Roscommon hospital and the surgeons and staff of the hospital work hard for 24 hours a day and deserve every credit they can get. The Coalition Government took office in 1973 and only then did negotiations start between the Western Health Board and various other interested bodies and from these negotiations the proposed federation emerged. Up to this time in line with Fianna Fáil policy the surgical and medical services of Roscommon hospital had been withdrawn.

I congratulate and compliment the Western Health Board on their efforts to have a surgeon and a physician appointed to Roscommon hospital. These posts were approved by the National Coalition Government and the date for their appointment was fixed before the last general election.

More notes.

Is it reasonable to expect people to travel distances of up to 90 miles to the various hospitals, to Ballinasloe, Portiuncula or Galway as the case may be? There is no public transport for our people to these areas. Medical card patients in particular will find the situation very difficult. I was glad to hear the Minister say that it was not a question of salary so far as the appointment of an obstetrician/gynaecologist is concerned but there are other more important aspects to be taken into consideration. What about the lives of mothers and babies? I fear very much for expectant mothers who, because of icy roads perhaps, cannot be taken by car to hospital. These are the sort of problems that should be taken into account. I urge the Minister to have section 41 of the Health Act amended and to ensure that an obstetrician/gynaecologist is appointed at Roscommon, at least for a trial period of two years as was suggested in relation to the federation.

Much play has been made of this issue in so far as the meetings of Roscommon County Council were concerned. Last evening I was reminded by the independent Fianna Fáil representatives from my area that I am not a member of the council. However, I would remind these two gentlemen that had they lived up to the agreement entered into in regard to co-option, I would be a member of that body.

It would be fine if we could co-opt a gynaecologist.

These are the people who talk of honour and integrity.

(Interruptions).

Deputy Burke, without interruption.

In most other instances, too, their selfishness overcame them and the grab-all policy of the latter-day soldiers of destiny persisted.

Latter-day saints.

There will be local elections next year.

Will the Deputy be standing as an independent?

I am putting the motion.

By way of explanation, while I accept——

Is the Minister proposing to reply?

The Minister may make a suggestion on the motion. I do not think he intends dealing with it in any way.

Deputy Mitchell is not yet a veteran of this House but if he takes his time he will learn.

The Minister, too, must abide by the rules of the House.

The Minister, on the vote.

Before the motion is put I should like to say that we on this side of the House accept fully the principle enshrined in the motion.

(Cavan-Monaghan): This is a second speech in an attempt to run with the hare and hunt with the hounds. The Minister is either for or against the motion.

The Minister is entitled to offer an explanation but not to make a speech.

I am putting forward a few words of explanation. I consider myself entitled to do that.

Yes, on the question of the vote.

Will Deputy Boland be allowed to reply, then?

I subscribe fully to the principle of the motion in so far as it calls for the implementation of a federation between Roscommon and Portiuncula hospitals. Unfortunately from my point of view acceptance of the motion would ask the Dáil to call on me to do something which I could not do statutorily, that is, to ensure that such appointments of professional staff as are necessary to honour the agreement be made without further delay. For that technical reason only I must oppose the motion.

Why has an amendment not been tabled?

I am putting the motion.

The motion asks the Minister to ensure that such appointments of professional staff as are necessary to honour the agreement be made without further delay. It is within the compass of the Minister to take those steps by way of amending legislation. We were loath to suggest that amending legislation be introduced but last night we suggested two alternatives that would have the effect of achieving the federation. It is wrong to say, therefore, that what the motion seeks cannot be implemented by the Minister. Deputy Leyden said in an interview which he is now trying to deny but which was reported in the Irish Independent of 26 August, that as the Government have a 20-seat majority there should be no problem in amending the legislation.

I must put the motion.

On a point of order, in relation to the wording of the motion, I have asked those associated with it to clarify which agreement they are referring to.

So far as the Chair is concerned, the motion was tabled. It is on the Order Paper and has now been discussed. The Chair must put the motion now. If the House were agreed on some other way out, the Chair would accept that but as there is no such agreement all the Chair can do is put the question.

According to this motion——

(Interruptions.)

We cannot have another speech on the motion. The debate has concluded.

May I not speak on a point of order?

The Deputy has not been raising a point of order. The motion was accepted by the Chair. It has been discussed and debate concluded on it.

(Interruptions.)

While the Chair is on his feet nobody else should stand up or try to talk.

Question put.
The Dáil divided: Tá, 41; Níl, 70.

  • Barry, Peter.
  • Barry, Richard
  • Begley, Michael
  • Bermingham, Joseph
  • Boland, John.
  • Bruton, John.
  • Burke, Joan.
  • Clinton, Mark.
  • Cluskey, Frank.
  • Collins, Edward.
  • Conlan, John F.
  • Cosgrave, Michael J.
  • D'Arcy, Michael J.
  • Deasy, Martin A.
  • Desmond, Barry.
  • Desmond, Eileen.
  • Donegan, Patrick S.
  • Donnellan, John F.
  • Enright, Thomas W.
  • Fitzpatrick, Tom (Cavan-Monaghan).
  • Harte, Patrick D.
  • Hegarty, Paddy.
  • Horgan, John.
  • Kenny, Enda.
  • L'Estrange, Gerry.
  • McMahon, Larry.
  • Mannion, John M.
  • Mitchell, Jim
  • O'Brien, Fergus.
  • O'Brien, William.
  • O'Donnell, Tom.
  • O'Keeffe, Jim.
  • O'Toole, Paddy.
  • Pattison, Séamus.
  • Ryan, John J.
  • Spring, Dan.
  • Taylor, Frank.
  • Timmins, Godfrey.
  • Treacy, Seán.
  • Tully, James.
  • White, James.

Níl.

  • Ahern, Bertie.
  • Ahern, Kit.
  • Allen, Lorcan.
  • Andrews, Niall.
  • Aylward, Liam.
  • Barrett, Sylvester.
  • Brady, Gerard.
  • Brady, Vincent.
  • Briscoe, Ben.
  • Brosnan, Seán.
  • Browne, Seán.
  • Burke, Raphael P.
  • Callanan, John.
  • Filgate, Eddie.
  • Fitzgerald, Gene.
  • Fitzpatrick, Tom (Dublin South-Central).
  • Fitzsimons, James N.
  • Flynn, Pádraig.
  • Fox, Christopher J.
  • French, Seán.
  • Gallagher, Dennis.
  • Geoghegan-Quinn, Máire.
  • Haughey, Charles J.
  • Hussey, Thomas.
  • Keegan, Seán.
  • Kenneally, William.
  • Killeen, Tim.
  • Killilea, Mark.
  • Lalor, Patrick J.
  • Lawlor, Liam.
  • Lemass, Eileen.
  • Leonard, Jimmy.
  • Leonard, Tom.
  • Leyden, Terry.
  • Loughnane, William.
  • Calleary, Seán.
  • Cogan, Barry.
  • Colley, George.
  • Collins, Gerard.
  • Conaghan, Hugh.
  • Cowen, Bernard.
  • Cronin, Jerry.
  • Daly, Brendan.
  • Davern, Noel.
  • de Valera, Síle.
  • Doherty, Seán.
  • Fahey, Jackie.
  • Farrell, Joe.
  • Lynch, Jack.
  • McCreevy, Charlie.
  • McEllistrim, Thomas.
  • MacSharry, Ray.
  • Meaney, Tom.
  • Molloy, Robert.
  • Moore, Seán.
  • Morley, P.J.
  • Murphy, Ciarán P.
  • O'Donoghue, Martin.
  • O'Hanlon, Rory.
  • O'Kennedy, Michael.
  • O'Leary, John.
  • O'Malley, Desmond.
  • Power, Paddy.
  • Reynolds, Albert.
  • Smith, Michael.
  • Tunney, Jim.
  • Walsh, Joe.
  • Walsh, Seán.
  • Wilson, John P.
  • Wyse, Pearse.
Tellers: Tá, Deputies McMahon and B. Desmond; Níl, Deputies P. Lalor and Briscoe.
Question declared lost.
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